Elsevier Pathology

Clinical Pathology: General Principles, Microbiology

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738) A 20-year-old college student presented to a student health facility complaining of blurred vision, excessive tearing, and sensitivity to light. She was referred to an ophthalmologist, who obtained a corneal scraping. This biopsy, as well as the student’s contacts lenses and contact cleaning solution, were sent to the laboratory for culture. After 48 hours, the hyaline fungus shown in see the figure was recovered from all three specimens. Which one of the following is the most likely etiologic agent of her fungal keratitis?

• Keratitis, an inflammation of the cornea, can be caused by bacteria, viruses, amoeba, and fungi. There have been reports of fungal keratitis related to contaminated contact lens solution.

• Fusarium spp. are frequently associated with eye infections as well as sinusitis, nail infections, and septic arthritis. Neutropenic patients can also have disseminated systemic infections.

• Fusarium colonies mature in less than 4 days and start off as white and cottony, but rapidly develop a pink to violet center.

• Microscopic examination demonstrates septate hyphae and large canoe-shaped macroconidia with three to five septa.

• Fungal keratitis is currently treated with natamycin for several months. More invasive infections usually require treatment with antifungals, such as amphotericin B, fluconazole, or voriconazole.

Fusarium keratitis–multiple states. MMWR. 2006;55:400-401.

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